Cancer: Taking Care of Your Teeth During Treatment

Mouth sores are ulcers that form in the soft tissue in and around your mouth including your tongue, gums, or lips. They can be caused by chemotherapy or radiation and can be mild.

If your mouth sores are severe, your doctor may recommend delaying your cancer treatment until the infection is healed. According to the Mayo Clinic, chemotherapy reduces your blood’s ability to clot and could cause mild to severe bleeding from mouth sores. Bleeding and painful sores could affect your ability to eat which causes more stress to the body. Be sure to speak with your oncologist and dentist throughout your treatment. 

Why are mouth sores common for cancer patients?

Chemotherapy and radiation work to destroy rapidly growing cells throughout your body. Unfortunately some healthy cells are affected in the process – including the cells in your mouth. Also because your immune system is low, your mouth is vulnerable to infection.

What can I do for relief?

Get a dental checkup and talk to your doctor about treatment options. They may be able to recommend topical treatments that can include coating agents which form a film to protect the sores or painkillers which can numb the sores in your mouth. Be careful when eating or brushing your teeth while taking numbing medication since you may not be able to feel if you are causing more damage. There are also over-the-counter products, such as fluoride toothpastes, that contain aloe vera and allantoin, which claim to be naturally soothing and gentle. Talk to your dentist about using these products.

Brush Your Teeth
Brush twice a day with fluoride toothpaste. You can soak your extra-soft toothbrush in warm water to make it softer. Don’t forget to brush your tongue!

Floss Daily
Flossing helps remove plaque between teeth. If your gums are sore or bleeding, be gentle and avoid those areas, but floss in between the rest of your teeth.

Watch What You Eat
Stay away from crunchy or spicy foods and alcohol. Your mouth can be very fragile during treatment. Steer clear of foods that can irritate your gums or mouth sores. This includes alcohol-based mouth rinses and alcoholic drinks which can burn mouth sores.

Rinse Your Mouth Often
This will help keep food and debris off of your teeth and gums. Rinsing often, along with regular brushing and flossing, may help to reduce the chance of dental decay and infection. Rinsing is also helpful after vomiting to keep the acids from damaging the enamel on your teeth. You may also want to reduce eating citrus fruit or other high acid foods. Avoid the use of alcohol-based mouth rinses since they can be irritating to mouth sores and dry mouth.

Here are some rinsing solution ideas from NIH:

o 1 teaspoon of salt in 4 cups of water
o 1 teaspoon of baking soda in 1 cup (8 ounces of water)
o One-half teaspoon salt and 2 tablespoons baking soda in 4 cups of water

Dry mouth happens when you don’t have enough saliva (spit). It is can be a side effect of certain medications, such as antihistamines, decongestants, pain killers, diuretics and many others. Dry mouth can cause a constant sore throat, burning sensation, trouble speaking, difficulty swallowing, hoarseness or dry nasal passages.

Why Is Dry Mouth Common for Cancer Patients?

Saliva is vital to our mouth health. It not only helps us break down and wash away food and bacteria from our teeth and gums, but it also provides disease-fighting substances throughout your mouth to help prevent cavities and other infections. For patients undergoing cancer treatment, the use of certain medications, chemotherapy and radiation can greatly reduce the amount of saliva produced by directly affecting the salivary glands. Less saliva may increase your risk of tooth decay.

What Can I Do For Relief?

See Your Dentist
Get a dental checkup and talk to your doctor about treatment options. They may recommend the use of artificial saliva and/or a fluoride rinse or gel which may reduce tooth decay caused by dry mouth.

Brush Your Teeth
Brush your teeth twice a day with fluoride toothpaste. You can soak your extra-soft toothbrush in warm water to make it softer. Don’t forget to brush your tongue, and avoid mouth rinses with alcohol in them since they may further dry your mouth.

Floss Daily
Flossing helps remove plaque between teeth. This is essential since your body is not producing an adequate amount of saliva to rinse inside your mouth. If your gums are sore or bleeding, be gentle and avoid those areas but floss in between the rest of your teeth.

Drink Plenty of Water

Limit drinking alcoholic beverages since they may cause further dryness. Ask your dentist if other options such as sugar-free candies or gum may be helpful for you.

 

Sensitive gums may be a sign of minor tissue swelling from chemotherapy and radiation or a more serious indication of gum disease. Symptoms may include tenderness, bleeding, inflammation or even loose teeth.

Why Are Sensitive Gums and Gum Disease a Concern for Cancer Patients?

Some cancer treatments, such as chemotherapy and bone marrow transplant, weaken your immune system. This can make your body vulnerable to bacteria and infection. The bacteria in the mouth can spread to the rest of the body. That’s why it is important to try to see your dentist soon after your diagnosis so that you may potentially treat any existing gum disease before undergoing cancer treatment.

What Can I Do for Relief?

See Your Dentist
Get a dental checkup and talk to your doctor about treatment options. They may recommend a topical anti-inflammatory or a steroid rinse. An antibacterial or antifungal rinse is also commonly prescribed. By keeping your mouth healthy prior to beginning your treatment you could potentially reduce the risk of further infection which could delay your overall treatment.

Brush Your Teeth
Brush your teeth twice a day with fluoride toothpaste. There are also over-the-counter products, such as fluoride toothpastes, that contain aloe vera and allantoin, which claim to be naturally soothing and gentle. Talk to your dentist about using these products. If your extra-soft tooth brush bristles are too hard, soak them in warm water to make them softer. Don’t forget to brush your tongue.

Floss Daily
Flossing helps remove plaque between teeth. If your gums are sore or bleeding, be gentle and avoid those areas, but floss in between the rest of your teeth.

Rinse Your Mouth Often
This will help keep food and debris off of your teeth and gums. Rinsing often, along with regular brushing and flossing, may help to reduce the chance of dental decay and infection. Rinsing is also helpful after vomiting to keep the acids from damaging the enamel on your teeth. You may also want to reduce eating citrus fruit or other high acid foods.

Here are some rinsing solution ideas from NIH:

o 1 teaspoon of salt in 4 cups of water
o 1 teaspoon of baking soda in 1 cup (8 ounces of water)
o One-half teaspoon salt and 2 tablespoons baking soda in 4 cups of water

Jaw and facial pain is a common side effect, especially if you have radiation therapy near your head or neck. Jaw and facial pain may include pain in or around the ear, tenderness of the jaw, pain when biting or headaches.

Why Is Jaw and Facial Pain Common for Head and Neck Cancer Patients?

Radiation therapy can cause inflammation and scarring around the jaw muscles. Another source of jaw pain may be a result of tooth grinding, which is often associated with stress.

What Can I Do for Relief?

Get a dental checkup and talk to your doctor about treatment options. If your jaw pain is attributed to tooth grinding and stress, talk to your dentist about treatment options, which may include muscle relaxants, exercises and anti-inflammatory medications.

To relieve stiff chewing muscles in your jaw, the NIDCR recommends opening and closing your mouth as far as you can without pain 20 times. Do this 3 times a day. Consult with your dentist for more recommendations.

Patients undergoing head and neck cancer treatments may experience a heavy metallic taste. Eating with plastic utensils helps, as does avoiding certain foods (usually those with higher acid).

 

An infection in your mouth can present itself in different ways. According to the NIDCR, you should contact your cancer care team if you see a sore, or a sticky, white film in your mouth or if you experience swelling or bleeding.

Why Is Infection Common In Cancer Patients?

Chemotherapy lowers your immunity, causing the germs that naturally live in your mouth to increase your risk for infections or make any infections you have worse. These mouth infections can be difficult to heal and if they are serious enough they may even delay your cancer treatment. It’s important to try to prevent them from happening in the first place.

What Can I Do for Relief?

Contact your cancer treatment doctors immediately. It will also be helpful to include your dentist.

Brush Your Teeth
Brush your teeth twice a day with fluoride toothpaste. There are also over-the-counter products, such as fluoride toothpastes, that contain aloe vera and allantoin, which claim to be naturally soothing and gentle. Talk to your dentist about using these products. If your extra-soft toothbrush bristles are too hard, soak them in warm water to make them softer. Don’t forget to brush your tongue.

Floss Daily
Flossing helps remove plaque between teeth. If your gums are sore or bleeding, be gentle and avoid those areas, but floss in between the rest of your teeth.

Rinse Your Mouth Often
This will help keep food and debris off of your teeth and gums. Rinsing often, along with regular brushing and flossing, may help to reduce the chance of dental decay and infection. Rinsing is also helpful after vomiting to keep the acids from damaging the enamel on your teeth. You may also want to reduce eating citrus fruit or other high acid foods.

Here are some rinsing solution ideas from NIH:

o 1 teaspoon of salt in 4 cups of water
o 1 teaspoon of baking soda in 1 cup (8 ounces of water)
o One-half teaspoon salt and 2 tablespoons baking soda in 4 cups of water